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POWER OF PNEUMA

Intake & Release Form

In an effort to make sure we cover some details prior to our session and to complete required processes, I ask that you take the time to complete the below form so we can proceed with grace and ease.

PERSONAL INFORMATION

Birthday

HISTORY

Have you ever had a Healing Session?
Yes
No
Have you ever heard of Emotional Healing?
Yes
No
If booking a QHHT Session, is this your first session?
Yes
No
N/A
Are you aware of the Chakra System?
Yes
No
Rating my level of Chakra understanding and knowledge.
No knowledge.
Knowledgeable and know they are our energy fields.
Semi-Knowledgeable and have worked with the Chakra System and know each meaning
Very knowledgeable and working with them on a frequent basis.
Expert and know how to open, close and clear each Chakra.

If participating in an Emotional Healing Energy Session, I understand that during an Emotional Healing Sessions, Energy Healing may take place. Emotional Healing refers to the process of acknowledging, accepting, processing, and resolving emotional pain, trauma, or negative patterns that may have resulted from past experiences, relationships, or situations. This healing process allows individuals to release trapped emotions, transform unhealthy emotional patterns, and restore emotional well-being, balance, and resilience. Aspects of Emotional Healing include acknowledgement of emotions, processing and understanding, self-acceptance and compassion, and ultimately releasing the negative energetic emotion.

If participating in a QHHT Session, I understand QHHT is considered an alternative or complementary therapy, and its effectiveness varies from person to person. While some individuals report profound experiences and positive outcomes, others may not experience the same level of impact.


The QHHT technique is designed to access a client's subconscious mind (also referred to as the "higher self" or "superconscious") to retrieve information that can promote healing, clarity, and insight. QHHT induces a deep state of hypnosis, often referred to as the theta brainwave state, which allows the client to access parts of their subconscious mind that are typically unavailable during normal waking consciousness. The goal of QHHT is to establish direct communication with the client’s higher self or subconscious, a part of the mind that holds profound wisdom, healing capabilities, and knowledge. The subconscious can provide information about the client’s physical, emotional, or spiritual condition and guide them toward healing. One of the unique features of QHHT is its potential for self-healing. During a session, the subconscious mind may offer explanations for physical ailments, emotional challenges, or life circumstances and, in some cases, facilitate instant healing or provide advice on how to improve the client's well-being. Unlike traditional hypnotherapy, QHHT practitioners do not suggest outcomes or interpretations to the client. The goal is to allow the client's higher self to provide answers and healing without external influence. A QHHT session typically involves an interview with the client, followed by the induction into hypnosis, where the practitioner guides the client through different life experiences (often past lives), and a session of communication with the higher self. The session may last several hours, and clients often report feeling deeply relaxed and insightful afterward.


Acknowledgement & Consent

Disclaimer

Voluntary Participation

Confidentiality

Release of Liability

Informed Consent

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